Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases

Kocur, Damian; Zbroszczyk, Miłosz; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Baron, Jan; Bazowski, P; Kwiek, S

doi:10.1016/j.pjnns.2016.07.008

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…The stent-assisted coil embolization technology helps to stabilize the coils in the aneurysm, and contributes to the treatment of complicated intracranial aneurysms [ 2 ]. Although many studies have confirmed its effectiveness and feasibility, the rare complications during perioperative period are still worth noting [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

et al. 2018

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BackgroundThe aim of this study was to retrospectively analyze the incidence of complications of intracranial complex aneurysms embolization by stent-assisted coils, and to investigate the causes of complications and corresponding treatment methods.Material/MethodsA total of 71 patients with subarachnoid hemorrhage (SAH) underwent stent-assisted coil embolization from 2015 to 2018 were enrolled in this study. Among them, 59 cases were single aneurysm, 12 cases were multiple aneurysms (11 cases with 2 aneurysms and 1 case with 3 aneurysms), for a total of 84 aneurysms. All enrolled patients received stent angioplasty except for 1 case.ResultsThere were 62 aneurysms (73.81%) treated with complete tamponade, 21 aneurysms (25.00%) treated with near-total tamponade and 1 aneurysm (1.19%) treated with partial tamponade. All aneurysms were evaluated based on GOS (Glascow outcome scale): 55 cases had GOS of 5 scores, 12 cases had GOS of 4 scores, 3 cases had GOS of 3 scores, and 1 case had GOS of 1 score. There were 67 SAH patients with good prognosis (GOS of 4–5 scores). In our study, the incidence of complications was 12.7%. Three cases experienced acute thrombosis, 2 cases experienced aneurysm rupture during embolization, and 1 case experienced postoperative focal ischemic changes with mild neurological deficits.ConclusionsStent-assisted coil embolization is safe, effective, and feasible for the treatment of intracranial ruptured aneurysms. Patients had a favorable outcome of as high as 94.4%. However, clinical skills should be improved to reduce the occurrence of complications. Prompt and timely treatment for complications of intracranial ruptured aneurysm is also of great significance.

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Section: Introductionmentioning

confidence: 99%

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

et al. 2018

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“…In the case of a clinically silent coil prolapse presented in the case of our database no interventional treatment was initiated. Because the blood flow in the parent artery was maintained we decided to treat the patient conservatively with aggressive antiplatelet therapy, as was presented in previous reports [35,36]. The clinical and radiographic course of our patient with 20-month follow-up proceeded uneventfully, suggesting that the expectant management is likely to be a safe treatment option for non-massive coil protrusions in small MCA aneurysms.…”

Section: Discussionmentioning

confidence: 65%

Endovascular treatment of small (< 5 mm) unruptured middle cerebral artery aneurysms

et al. 2019

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Purpose We report our experience with endovascular treatment of these lesions, with special consideration of angiographic and clinical outcomes and periprocedural complications. Material and methods The analysis included treatment results of 19 patients with 20 aneurysms. The aneurysm size ranged from 1.9 to 4.7 mm (mean 3.8, SD 0.7). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially postembolisation and at a minimum follow-up of six months. Results Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 19 (95%) cases and incomplete occlusion in one (5%) case. Imaging follow-up, performed in 17 (89.4%) patients, showed no change in the degree of occlusion in 16 (94.1%) patients and coil compaction in one (5.9%). There were no retreatment procedures. The procedure-related mortality rate was 5% (1/20) and was associated with intraprocedural aneurysm rupture. There was a case of a clinically silent coil prolapse into the parent artery. The clinical follow-up evaluation achieved in 17 (89.4%) patients showed no change in clinical status in all followed patients. Conclusions Endovascular treatment of small unruptured middle cerebral artery aneurysms is feasible and effective. The procedure-related complications are not negligible, especially in terms of the benign natural course of these lesions.

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“…Others include, coil migration, stent migration, stent thrombosis and delayed aneurysm rupture [9], however these complications are rare. Kocur et al [17] reported 2.9% (n = 1/34) periprocedural complication. This was related to prolonged retrieval of migrated coil in the anterior cerebral artery with consequent large infarction.…”

Section: Discussionmentioning

confidence: 96%

Intracranial stents in the management of wide-neck intracranial aneurysms

Sarkodie¹,

Jimah²,

Anim³

et al. 2021

HSI Journal

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Intracranial aneurysms are bulges in vessels that are prone to rupture with attendant morbidity and mortality. Early detection and treatment can avoid rupture and its associated consequences. Endovascular treatment of aneurysms with wide neck can be challenging due to potential coil migration or protrusion. The use of intracranial stents and balloons can help overcome some of these management challenges. We present 3 cases of endovascular treatment of wide-neck intracranial aneurysms. The first patient presented with a wide-neck left middle cerebral artery aneurysm that was successfully treated with stent-assisted coiling with complete obliteration of the aneurysmal sac. The second patient presented with a large, cavernous internal carotid artery aneurysm that was successfully treated with a flow diverter stent with complete obliteration of the aneurysm while the third case presented with a wide-neck left posterior communicating artery aneurysm and was also successfully treated with stent-assisted coiling. Even though endovascular treatment of wide-neck intracranial aneurysms is technically challenging, the evolution of new treatment techniques such as the use of stents and stent-assisted coiling make these treatments safe.

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Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases

Cited by 9 publications

References 27 publications

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Endovascular treatment of small (< 5 mm) unruptured middle cerebral artery aneurysms

Intracranial stents in the management of wide-neck intracranial aneurysms

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Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases

Cited by 9 publications

References 27 publications

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Endovascular treatment of small (&lt; 5 mm) unruptured middle cerebral artery aneurysms

Intracranial stents in the management of wide-neck intracranial aneurysms

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Endovascular treatment of small (< 5 mm) unruptured middle cerebral artery aneurysms